How a movie, physics and my day-to-day nerdy life combine

Patrick and I went on a date tonight to see the movie about Stephen Hawking, The Theory of Everything.  I have been wanting to see it since I saw the preview a couple months ago and finally we had some time (read: I have a treatment planning exam this week and am on call next weekend, so I wanted to be “normal” and also simultaneously procrastinate).

I was impressed.

Not only did I get to nerd out a little bit (although science and/or medicine weren’t the main focus of the movie), but it was at times funny, and heartwarming and sad, much like life is.  It was quite a journey.

Seriously though… I would watch it again.  Happily.

Then, we went home and spent an inordinate amount of time nerding out in a different way by looking into how true to life the movie really was, how the actor learned to portray gradual motor neuron decline so well and all that good stuff.  Apparently, it is pretty close to life, although there were, of course the odd composite characters and embellishments or sugar coating.  And the actor studied a ton with dancers and videos and such to get the movements (or absence thereof).

All in all, a good movie.

And now I want to read the book (written by his ex-wife, Jane).  In fact, I saw it while we were out and about today and I almost told Patrick I couldn’t see the movie before I read the book (since that is my general life rule), but I decided against that.  And I need to read his book too, because I like to be well-read and because I love science and physics (and I do firmly believe that much of it does point to God).

Also, it reminded me that physicists are some of my favourite kinds of people.  Seriously… I work with a ton of them… Not cosmologists or theoretical physicists, but medical physicists who are equally nerdy and insanely intelligent.

This in turn reminds me that before I read these books I should probably study my physics and radiobiology so that I pass them this year (although that is improbable because as a rule that doesn’t happen and we repeat them in 4th year).  And that in turn makes me continue to put that stuff off because it is way too early.  And as I said, I have a treatment planning exam this week that I need to study more for because it is on prostate and I haven’t worked with a doc who treats prostate in almost 2 months, so I am way rusty (and realistically never got the hang of it particularly well).  There is, of course some physics in there, so I guess it all relates back.  Kind of.

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Head and Neck

I got an email with the topic for my very first treatment planning exam.

Aside… A treatment planning exam is an oral exam where we get grilled on our management of patients from presentation to treatment and follow-up to help us practice for our licensing exams at the end of residency.  It can include basic questions right up to referencing why we do treatment in a certain schedule and where a target its. They start in third year, which is where I am now.  They are supposed to start off easier and get harder as time goes by.  At least in theory.

The site is “Head and Neck.”

Agh!

My issue with this?

Head and neck is probably one of the most difficult sites to treat and master.

I mean, we don’t do much head and neck related stuff in med school or even the first two years of residency and then, bam!  I’m treating cancers there.

At least, I have for the last two and a half weeks of this rotation.

I like head and neck.  I have said it is likely a site I’ll want to treat.  That doesn’t mean I feel anywhere near confident in it.

And it is my first exam.

When I opened the email, I just cracked up laughing.

Apparently most people get something like bone metastases from another primary.  Nope, not me.

Maybe it will be more simple than it sounds.

But, I don’t feel optimistic.

It is going to force me to read more.  But, I really was hoping for a relaxing weekend home.

That is how life works.  And how residency works.

Learning is good.  Looking stupid is part of learning.  I just need to embrace that.

Thank goodness Dr. Bond gave me some notes and tips.

I just hope my examiners remember I’m just in third year.

Top Ten (Twelve) Characters Who Would Have Sat At My Table In High School

I’m a day late but this week’s Top Ten Tuesday with the Broke and Bookish was too awesome to pass up. The list is the top ten characters who would have sat at my table in high school.5f1e1-toptentuesday

My table in real high school was a bit of a mixed bag. There were other nerds like me, and then the odd people we acquired and the people we were friends with as a result of various activities (mainly band and musical and yearbook. Half the time I was busy with some lunch time activity like choir or band or various yearbook meetings. But, when I was at the table, it was an interesting time. We often filled more than one table (shockingly) and did “crazy things” like build condiment castles one day and then spend the next cramming for that IB bio test we were all going to fail.

So, I expect my bookish high school table to be similar…

  • Hazel, Gus and Isaac from The Fault in Our Stars by John Green. I’m serious. Hazel is basically teenage me in a lot of ways, so I’m sure we would have gotten along. And the guys are very much like some of my friends in high school complete with the randomness and interesting characteristics that make them unique.
  • Quentin, Ben and “Radar” from Paper Towns by John Green. Maybe I like his books because he basically writes about characters I get or would have known. Either way, these guys all meet my table criteria. Quirky and nerdy for the win!
  • Eleanor from Eleanor & Park by Rainbow Powell. Misfits and outsiders were welcome. In fact Eleanor reminded me a lot of a couple people we hung out with in junior high and high school. Plus, I would have enjoyed their awesome taste in music.
  • Clay from Thirteen Reasons Why by Jay Asher. Because the token nice, smart shy guy has to eat somewhere.
  • The 4 girls from The Sisterhood of the Travelling Pants by Ann Brashares. Yes, all 4 of them. Because they are basically my 3 closest friends and I anyway, so why not include them all at the table?

Well, that is 12 people, so I guess the table is too full.  I think it is just a bit cozy.

What characters would have been at your lunch table?

Dance Party… Residents’ room edition.

Dr. Bond and I had a mini dance party in the residents’ room yesterday to this song.

Let’s face it.  It is an awesome song.  And dancing is great stress relief.

I am sure the social worker in the office next door thinks we are crazy.  That being said, I am pretty sure she already knows that by hearing some of our conversations across the office.

I have developed a new love for the website rdio.  Partly because the hospital hasn’t blocked it yet and partly because it lets me listen to various playlists and CDs without killing my phone or my pocketbook.

Yesterday was contouring to 50s and 60s music.  

A couple weeks ago, I was working on my research to Boomfalleralla by Afasi Filthy from The Fault In Our Stars soundtrack (ps the movie is almost as good as the book and the soundtrack is equally as good as the book.  I then went down a rabbit hole listening to more music from this Swedish group.  

Another day it was clinic prep to cover songs.

You get the picture.  I really like some background noise, especially when I am doing stuff requiring concentration.  Not everyone else does, but it works for me.  And it makes for some priceless “what are you listening to!?!?” moments, as well as the odd dance party.

Whatever gets the job done, I suppose.   

How Did That Happen?: How Did I Pass That Exam?

I have that sleepy and yet high energy feeling that comes from a post-exam hangover. Yes, ladies and gentlemen, I am done junior physics (minus the exam review) so long as I pass that exam.stethoscopes1

That brings me to this week’s “How Did That Happen?” post – how did I pass that exam?

Pick the answer you actually want to pick. My thing today (although passed exam is still kind of up in the air) was in one of the multiple choice questions I had to select an energy for an electron beam to cover a tumor but not kill the spinal cord. I misread the question initially and puzzled over it thinking photon beams (for everyone except the, like two people who understand this, photon and electron beams behave pretty differently). Then, when I was checking the exam over, I noticed my error and did the very simple math to pick an appropriate beam. I was debating two answers, then circled one as the person came to pick up the exams. I walked out and realized I had circled the wrong one. The definitely wrong one. Minus one point. The big question is did I pass that exam?

Don’t change answers. Someone told me this in undergrad and I struggled to believe it. Odds are, your first instinct was right and whatever you change it to is wrong, unless you are certain of your error. I had to do a mini analysis (because heaven forbid I believe things at face value, I say that makes me a true scientist), but it is true.

Get the right exam questions. When I wrote the MCAT, it was the first year it was offered on computers (that dates me) and there was some weird computer error where one of my verbal reasoning passages did not correspond to the questions at all. I just guessed all of my answers.

Efficiency or gas masks. I have a terrible taste (and smell) aversion to bananas. All through med school, the guy who was after me in alphabetical order liked to eat a banana part way through every exam. He ripped it out when he was about to check over his answers.   After having to sit through his banana stench once or twice, I developed a system. I would do the exam as fast as possible and bail before he ate the banana. It worked for almost every exam.

More efficiency.  There are time limits.  If you are like me and always finish exams early, stick with that because the one time you start to run behind, that will be the time that they will make you stop writing at the right time and act all unforgiving about it.  At least that is how my neuroanatomy exam went down.  Also, when you aren’t used to being there at the end, you do what I did today and pick the wrong answer because you get weirded out by the exam being over when you are just finishing checking it.

Choose your seats wisely. Because I am a creature of habit, I always sat by banana guy, even when I had options. I had a friend with OCD who had to sit in a seat based on some internal numbering system. I had another friend who couldn’t have anyone within eyeshot.  During part one of the LMCC, I sat between two friends, one of which had a bunch of candy we binge ate before the exam started.  Delightful.

Go in the room. During the LMCC, one of the doors to one of the rooms was sticky. I went to knock and go in the room and it wouldn’t open. I body slammed it and it still wouldn’t open. I started to panic. Then, I charged at the door and went bursting out the other side to almost land on the “patient.” Whoops.

Show up, preferably on time. I always want to punch the late person who makes things start late in the face. Or the person who fails to show up and makes things late. Don’t have me want to punch you.

Talk fast.  Many medicine exams are verbal and you need to cover a ton of information in not a lot of time.  In preparation for OSCEs, I had a few friends who I studied with by practicing old stations and suggested stations from textbooks. We timed ourselves and did every station at least twice as patient, examiner and student. As a result, we had memorized most possible stations and responses. I went into one room and hammered through a long exam, differential and a question in what was probably record time to have the examiner laugh at me because he hadn’t heard someone speak so quickly before. Its a gift.

Don’t whip the patient. Same OSCE. Just got done a psychiatry station which meant my stethoscope was in my pocket and not around my neck where the person could hypothetically strangle me (seriously, pro tip: you got points or lost points for this, can’t remember which). Next station was a cardiac exam. Whent to haul out stethoscope and it got caught in my pocket. Somehow then came sailing out to smuck the med 1 (because they make the best cheapest exam patients).

Tell them what they want to hear. Oral exams are probably one of the more daunting exams in med school. There is something bizarre about explaining your way through hypothetical cases. Someone once told me to include all details you think are relevant and do it in a systematic way as if there was a patient in your face. This becomes more challenging when you have the peds sick and can barely speak and then the fire alarm goes off.

Do what they say. If someone says wear a lab coat or bring a calculator, do it. I have heard of people who failed or lost significant marks for professionalism for not wearing a lab coat, not bringing a stethoscope or not having the stuff they need to actually do the exam.

Turn off your phone/pager. Seems simple. There is almost always one. Nothing sucks more than being that kid with the pager going off while everyone is writing the exam. And not thinking it is yours until someone pinpoints your bag. Then, having to creep forward to turn it off from the very back of the room while people stab you with their eyes.

Study the right material. Seems simple most of the time. I had an anatomy exam in the middle of our course in med 1 where the instructors failed to communicate and included a section we had barely covered and omitted another piece of anatomy we thought was on the exam. That makes for some mighty angry med students.

Put your name and student number on the exam. Why is this still an issue at this level of education? Looking back, I didn’t put my name on last year’s physics exam… Good thing there was only two of us.

If at all possible, read your examiner’s mind. The good old “guess what I’m thinking.” Agh. Sometimes, you can perceive the nods or redirects in an oral exam, but written or a stone faced examiner are more challenging. Psychic abilities are always helpful when trying to figure out what someone is actually wanting to know in that question or why the person administering your oral exam keeps cringing (is it just indigestion or is it my stupidity?).

What are some of your exam conundrums and how did you pass?

Physics Avoidance

I have been eaten by physics.

Okay, I really like physics, but I have this exam coming up on Thursday (unless someone decides to move it again).  And unlike last year, I have to pass it this time around.  Silly world expecting me to actually know stuff.

Needless to say, I goofed off all last week on vacation with my parents visiting and such (and before that it was manuscript writing), so this week is hammer time with the physics books, well, that and showing up to my Molecular Genetics classes and labs and watching playoff hockey (please don’t let tonight be the last game for the Habs, please!?!?).

And yet, I am here, writing a post.  It will be short and sweet and simply some randoms.

I finished The Rosie Project by Graeme Simsion on Sunday night (it was my final act of vacation… That and staying up late to watch the hockey game, but I do that during the playoffs without vacation, so it doesn’t count).  It was one of the better books I have read recently.  I can relate to the main character who has a Sheldon Cooper-like (and thus, in some ways, a Trisha-like) personality.  Very funny, very easy read.  You should check it out.

The Child and I, after about 2 years of playing Super Mario Brothers on the Wii have made it to level 3.  If you can’t guess based on the timeline, we die a lot.  And level 3 is filled with us screaming “PENGUINS” and then dying.  I think it makes the death more fun.

My “nephews” turn 12 next week.  They are the same age as the kids Patrick teaches.  That makes me feel so freaking old.  It also makes me remember I need to get them cards.

I have discovered during this Molecular Genetics rotation that DNA is beautiful.  Especially when being analyzed by FISH or SKY.

Spectral karyotyping. I love the pretty colours.

BCR/ABL is an abnormal fusion gene that is found in leukemias. Image from Wisconsin State Laboratory of Hygiene.

My herbs are sprouting!  I have no clue what is what.  Hopefully that will become more clear as they mature.

On another plant related note, Jeter killed our orchid.  Snapped it clean in half.  Jerk.

Jeter broke a mug at 3am.  Well, we assume it was him.  Or we have a poltergeist.  Or a clumsy thief who forgot to steal stuff.  Really, this is another reminder why we shouldn’t leave stuff on the counter.  It is also why I am grateful that I sleep like I am dead because Patrick had to wake up and deal with it.

Speaking of my destructive cat, the Child showed me these videos on YouTube called Simon’s Cat.  I find them delightful.

Patrick is going on a field trip this week with his class overnight.  He is excited.  I can think of few things I would want to do less than hang out at a camp with a ton of 11 and 12 year olds.  That is what makes us different.

Being a Leisurely Commuter

It was a good morning.

I was seeing some consults at another hospital and I was told to show up at 9:45.  That is basically halfway through the day.

I got up around the same time and went downtown for coffee and some physics studying.  I love doing work with caffeine, food and the bustle of people heading out for the day.  Especially with a good view and Eddie Vedder playing in the background.IMG_0036 IMG_0037

I then commuted using the ferry.  Yes, the ferry.  I never get to travel by ferry.  It is more awesome than the subway, in case you are wondering.  IMG_0040

I then took a more scenic walking trail to the hospital.  Although, I did get a bit lost, it was worth it.IMG_0043

I concluded I could do this.  Be a ferry commuter, specifically.  If every day was as sunny and leisurely as this morning.  But when the weather sucks (or I just want to sleep as late as reasonably possible), I am glad I am close to the hospitals I usually work at.

Really, I am a commuter.  I take the bus or walk every day now that Patrick has a real job that sends him an hour out of town every morning (meaning he leaves at 7 in the morning every day).  That kind of commuting just isn’t as novel to me.  The having a husband with a REAL teaching job (at least until the end of the year) is, though, so I like it nonetheless.

Even finding out my physics exam was rescheduled AGAIN couldn’t ruin my morning.  Okay, it did have me agitated most of the day, but it is a growing experience.

Stunned in a sea of infection

I am stunned in a sea of infection.

No, I do not have a delirium.  I just happen to be rotating through Infectious Diseases (herein ID).

I haven’t felt this dumb in a few rotations.

Image via escapeinabook.blogspot.com.

Okay, I haven’t been on a new rotation in a few rotations, so I guess that it is fair game.

But still… Last time I felt this stunned was Bone Marrow Transplant and prior to that, Cardiology.

I wish it was as cool as running around in hazmat suits trying to ward off the next pandemic superbug.  And some days, it feels a tiny bit like that.  Most of the time, it involves looking at stinky post-op wound infections (oh boy, did I ever smell a doozy today) and trying to sort our prolonged febrile neutropenias.

I like the detective work that can come from ID.  Sometimes, you have to piece together the presentation and patterns in fevers or bacteria to figure out the cause.  Sometimes, you get to find that kind of rare, super cool cause of something.  Just like on  House, MD but without the overqualified and giant team who can do whatever they basically want around the hospital… So, not really like that at all.

Image from housemdconfessions.tumblr.com.

I love the problem solving side of consult-based medicine.  The swoop in a problem solve is cool, but as I think I have said before, I much prefer the continuity of care that is being the prirmary caregiver.

But back to my feeling stunned…

I have never been a big one for microbiology and things.  Antibiotics are a big black box.  I know the go to antibiotic for the common problems and beyond that, I look it up or, well, call ID.  And anything beyond your common yeast infection or virus is basically outside of my comfort zone.

Thus, I find it challenging to sort out a lot of these cases.  It isn’t in my natural knowledge base and sometimes, I struggle even to know how or where to look it up.I get that this is the reason why we do this rotation.

I just hate that floundering feeling of seeing consults and follow-ups and sometimes not really having a clear grasp of what the plan is or will be.  And yes, that happens on most rotations at times, but as you learn, it happens less and less.  It just seems that hopping to this rotation, it is currently happening more and more.

It all comes with time and experience and reading. But until then, it also comes with a lot of, “I’ll look that up” or “I need to talk to my staff doctor about this” and, of course, the “I don’t know.”  Oh, and a lot of changes to my “assessment and plans,” which make me cringe a little.

That is the thing with medicine, the more you learn, the more you learn you don’t know.  This is yet again another area where I clearly don’t know a lot… At least I figured out that much.

LMCC est fini part two

A year and a half ago I wrote the first part to this post.  Well, kind of.  Check it out here.

A year and a half ago, I finished the first part of the LMCC.  It was a traumatic exam at the end of my fourth year of medical school.  I was warned that it would feel like I failed, but that in reality almost all Canadian grads pass it.

Today, I finished the second part of the LMCC.  This was the practical part.  The part where we wander from room to room pretending to be doctors while people pretend to be patients and then we answer questions about how we would doctor them in real life.    I was warned that it would also feel like death.  But again, that most Canadian, English as a first language grads do okay with it.

That being said, I seem to know a disproportionate number of people who failed.

That gave me some significant test taking anxiety.

I mean, I can count on one hand the things that count that I failed.  And by that, I really can only think of one thing.  And really, I was expected to fail that.

But still, between my intense imposter syndrome, my usual performance anxiety and the terror that comes from exams that cost almost my entire month’s pay and basically are necessary to my future employment, I was fearful.

Fearful is actually probably not the best word.  I was scared poopless.  In fact, I had the worst exam anxiety that I have had in a long time.

But now it is done.

If you landed here looking for exam advice.  I have none except do some studying and be a good doctor and expect to forget something at most stations.

I can’t really say anything else in detail because the LMCC exam people are very serious about the whole not talking about the exam thing and talking about the experience in any further detail beyond me saying that it was a practical exam could get me in to big trouble.  Like losing my current credentials, legal action and all around badness kind of trouble.  I like my license.  And I really don’t want to have to do exams over again.  And I really, really don’t like any kind of trouble.

It doesn’t matter because I am done.  Hopefully, forever.  And if not, at least until Spring.

Now, just to wait the month or two before the results miraculously appear in my inbox.

To make me feel better we booked our free flights and started planning a trip to New York in the Spring.  I am so excited for that.

I am also pumped to get back to the rest of my life!

MCAT Flashbacks

I am on call again this weekend.

As I walked in to the hospital where I did my undergrad early-ish on this foggy Saturday morning, I was brought back to an earlier time.

Generally only music seems to bring me back like this, but Saturday morning hospital had a similar effect today.

When I was doing my undergrad, I was also studying for the MCAT (big giant (redundancy is necessary there) exam needed to apply for medical school).  I wrote twice… Once at the end of the summer between 2nd and 3rd year and once in January of 3rd year.  Both times involved much studying over holidays and weekends when the hospital is less busy (less is the necessary word because hospitals never really sleep).

Today, the hospital looked almost just like it did when I was in the middle of that fun.  And I had to run to the library to try to research something and the library was creepy empty, just like it was when I was studying.  The table arrangement changed.  There are computers where my favourite table by the one window that didn’t leak (probably because it is still the one window that doesn’t leak).

Studying for the MCAT was a form of torture.  For one, it was above and beyond everything else I was doing.  And, as I alluded to previously, I spent a great deal of round two feeling extremely self-defeated.  There was stuff on there that my non-traditional degree program never covered.  I spent weeks with an organic chemistry textbook trying to learn enough to pass. I memorized amino acids.

The studying invaded my life.  I helped with a youth group camping trip and wound up with my book on the beach for part of the day just to meet my self-imposed quota.  I would go to the hospital to be at the library for the afternoon before going out with Patrick (please note, we had just started dating and I am pretty sure he thought I was bat crazy… Not far from the truth).

I am a bit odd.  I actually love to study and learn.  LMCC studying wasn’t too bad for the first while (it got old once the pressure was on, but still…).  The MCAT was never that fun.  It was either stuff I consider impossible to study, stuff I had never heard before and then the stuff I already knew.  Very minimal in between.  I still embraced the MCAT studying for the most part.

Sitting in that library brought me back to the beginning.  How wide eyed and ambitious I was.  How awful that studying was compared to the things I am learning now.  How much less naïve and somehow more knowledgeable I have become.

The whole thing made me crave McDonalds and pop slushies (the study food of champions) and miss my MCAT study buddy, J, who is now in theatre school halfway across the country (a bit of the opposite end of the spectrum school wise too).

It is strange how something that seemed fairly terrible at the time with little hints of fun can, in retrospect, bring back almost fond memories.  I look back at that time and feel glad that I am where I am, but I kind of miss the job I had at that time and some of the people I spent time with and that library (though, I am here for two months, so I am sure I will see more of that).

Love the flashbacks.

Now, to end with a music flashback circa my MCAT season playlist.